{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,17]],"date-time":"2026-07-17T12:21:18Z","timestamp":1784290878719,"version":"3.55.0"},"reference-count":58,"publisher":"SAGE Publications","issue":"6","license":[{"start":{"date-parts":[[2023,8,1]],"date-time":"2023-08-01T00:00:00Z","timestamp":1690848000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Journal of Child and Adolescent Psychopharmacology"],"published-print":{"date-parts":[[2023,8]]},"abstract":"<jats:sec>\n                    <jats:title>Background:<\/jats:title>\n                    <jats:p>Treatment of obsessive-compulsive disorder (OCD) in children and adolescents frequently involves cognitive behavioral therapy (CBT), selective serotonin reuptake inhibitors (SSRIs), or their combination. However, how adding CBT to SSRIs affects the trajectory and magnitude of improvement has not been evaluated meta-analytically.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods:<\/jats:title>\n                    <jats:p>We performed a meta-analysis using weekly data from prospective randomized parallel group trials of CBT and SSRIs in pediatric patients with OCD. Response was modeled for the change in the Child Yale-Brown Obsessive-Compulsive Scale (CY-BOCS) using a Bayesian hierarchical model over 12 weeks.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>\n                      Fourteen studies included pharmacotherapy arms, 4 studies included combined pharmacotherapy and psychotherapy, and 10 studies included a placebo or control arm. The studies included 1146 patients (mean age 12.7\u2009\u00b1\u20091.3 years, mean 42.1% female). In the logarithmic model of response, statistically significant differences in treatment effects for CBT+SSRI and SSRI monotherapy were observed compared with placebo (SSRI\n                      <jats:italic toggle=\"yes\">\u03b2<\/jats:italic>\n                      \u2009=\u2009\u22123.59, credible interval [95% CrI]: \u22124.13 to \u22123.02,\n                      <jats:italic toggle=\"yes\">p<\/jats:italic>\n                      \u2009&lt;\u20090.001; SSRI+CBT\n                      <jats:italic toggle=\"yes\">\u03b2<\/jats:italic>\n                      \u2009=\u2009\u22124.07, 95% CrI: \u22125.05 to \u22123.04,\n                      <jats:italic toggle=\"yes\">p<\/jats:italic>\n                      \u2009&lt;\u20090.001). Adding CBT to an SSRI produced numerically (but not statistically significantly) greater improvement over 12 weeks. Greater improvement was observed in studies with more boys (\n                      <jats:italic toggle=\"yes\">p<\/jats:italic>\n                      \u2009&lt;\u20090.001), younger patients (\n                      <jats:italic toggle=\"yes\">p<\/jats:italic>\n                      \u2009&lt;\u20090.001), and in studies with greater baseline symptom severity (\n                      <jats:italic toggle=\"yes\">p<\/jats:italic>\n                      \u2009&lt;\u20090.001).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions:<\/jats:title>\n                    <jats:p>In children and adolescents with OCD, compared with placebo, both SSRIs and SSRI+CBT produced early and sustained improvement over 12 weeks, although the improvement was also related to sample characteristics. Longer term studies are needed to determine when the additive benefit of CBT emerges relative to SSRI monotherapy.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1089\/cap.2023.0018","type":"journal-article","created":{"date-parts":[[2023,6,22]],"date-time":"2023-06-22T17:42:50Z","timestamp":1687455770000},"page":"203-211","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":14,"title":["What Is the Added Benefit of Combining Cognitive Behavioral Therapy and Selective Serotonin Reuptake Inhibitors in Youth with Obsessive Compulsive Disorder? A Bayesian Hierarchical Modeling Meta-Analysis"],"prefix":"10.1177","volume":"33","author":[{"given":"Eric M.","family":"Mendez","sequence":"first","affiliation":[{"name":"Department of Psychiatry &amp; Behavioral Neuroscience, College of Medicine, University of Cincinnati, Cincinnati, Ohio, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Katherine K.","family":"Dahlsgaard","sequence":"additional","affiliation":[{"name":"Private Practice, Philadelphia, Pennsylvania, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"John M.","family":"Hjelmgren","sequence":"additional","affiliation":[{"name":"Department of Psychiatry &amp; Behavioral Neuroscience, College of Medicine, University of Cincinnati, Cincinnati, Ohio, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jeffrey A.","family":"Mills","sequence":"additional","affiliation":[{"name":"Department of Economics, Lindner College of Business, University of Cincinnati, Cincinnati, Ohio, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vikram","family":"Suresh","sequence":"additional","affiliation":[{"name":"Department of Economics, Lindner College of Business, University of Cincinnati, Cincinnati, Ohio, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7526-2641","authenticated-orcid":false,"given":"Jeffrey R.","family":"Strawn","sequence":"additional","affiliation":[{"name":"Department of Psychiatry &amp; Behavioral Neuroscience, College of Medicine, University of Cincinnati, Cincinnati, Ohio, USA."},{"name":"Divisions of Child &amp; Adolescent Psychiatry and Clinical Pharmacology, Department of Pediatrics, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2023,8,16]]},"reference":[{"key":"e_1_3_4_2_1","doi-asserted-by":"publisher","DOI":"10.1177\/0145445502026004001"},{"key":"e_1_3_4_3_1","doi-asserted-by":"publisher","DOI":"10.1186\/s13034-022-00537-z"},{"key":"e_1_3_4_4_1","doi-asserted-by":"publisher","DOI":"10.1007\/s10567-015-0184-8"},{"key":"e_1_3_4_5_1","volume-title":"Diagnostic and Statistical Manual of Mental Disorders","author":"American Psychiatric Association","year":"1994","unstructured":"American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders, 4th ed. American Psychiatric Association: Washington, DC; 1994.","edition":"4"},{"key":"e_1_3_4_6_1","doi-asserted-by":"publisher","DOI":"10.1176\/appi.books.9780890425596"},{"key":"e_1_3_4_7_1","doi-asserted-by":"publisher","DOI":"10.1097\/01.chi.0000177324.40005.6f"},{"key":"e_1_3_4_8_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.pnpbp.2005.11.003"},{"key":"e_1_3_4_9_1","doi-asserted-by":"publisher","DOI":"10.1137\/141000671"},{"key":"e_1_3_4_10_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jaac.2015.01.011"},{"key":"e_1_3_4_11_1","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2011.1344"},{"key":"e_1_3_4_12_1","doi-asserted-by":"publisher","DOI":"10.1080\/15374416.2018.1496443"},{"key":"e_1_3_4_13_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jaac.2010.06.013"},{"key":"e_1_3_4_14_1","first-page":"1682","article-title":"Turing: A language for flexible probabilistic inference","volume":"84","author":"Ge H","year":"2018","unstructured":"Ge H, , Xu K, , Ghahramani Z. Turing: A language for flexible probabilistic inference. In: Proceedings of the Twenty-First International Conference on Artificial Intelligence and Statistics. Proceedings of Machine Learning Research, 2018; 84:1682\u20131690.","journal-title":"In: Proceedings of the Twenty-First International Conference on Artificial Intelligence and Statistics. Proceedings of Machine Learning Research"},{"key":"e_1_3_4_15_1","doi-asserted-by":"publisher","DOI":"10.1176\/appi.ajp.160.11.1919"},{"key":"e_1_3_4_16_1","doi-asserted-by":"publisher","DOI":"10.1097\/00004583-200107000-00011"},{"key":"e_1_3_4_17_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jaac.2011.09.019"},{"key":"e_1_3_4_18_1","doi-asserted-by":"publisher","DOI":"10.1001\/archpsyc.1989.01810110054008"},{"key":"e_1_3_4_19_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jaac.2018.06.032"},{"key":"e_1_3_4_20_1","doi-asserted-by":"publisher","DOI":"10.1080\/15374416.2015.1046177"},{"key":"e_1_3_4_21_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.psychres.2018.09.054"},{"key":"e_1_3_4_22_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.psychres.2015.01.015"},{"key":"e_1_3_4_23_1","doi-asserted-by":"publisher","DOI":"10.1111\/jcpp.13155"},{"key":"e_1_3_4_24_1","doi-asserted-by":"publisher","DOI":"10.1097\/00004583-200107000-00010"},{"key":"e_1_3_4_25_1","doi-asserted-by":"publisher","DOI":"10.1007\/s10802-014-9917-2"},{"key":"e_1_3_4_26_1","doi-asserted-by":"publisher","DOI":"10.1111\/jcpp.12344"},{"key":"e_1_3_4_27_1","volume-title":"OCD in Children and Adolescents: A Cognitive-Behavioral Treatment Manual","author":"March JS","year":"1998","unstructured":"March JS, , Mulle K. OCD in Children and Adolescents: A Cognitive-Behavioral Treatment Manual. Guilford Press: New York, NY; 1998."},{"key":"e_1_3_4_28_1","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2018.17977"},{"key":"e_1_3_4_29_1","doi-asserted-by":"publisher","DOI":"10.1002\/da.22389"},{"key":"e_1_3_4_30_1","doi-asserted-by":"publisher","DOI":"10.1037\/a0012652"},{"key":"e_1_3_4_31_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jaac.2019.10.013"},{"key":"e_1_3_4_32_1","doi-asserted-by":"publisher","DOI":"10.1007\/s10578-021-01240-4"},{"key":"e_1_3_4_33_1","doi-asserted-by":"publisher","DOI":"10.1007\/s10826-013-9742-1"},{"key":"e_1_3_4_34_1","doi-asserted-by":"publisher","DOI":"10.1001\/jama.292.16.1969"},{"key":"e_1_3_4_35_1","doi-asserted-by":"publisher","DOI":"10.1037\/a0038402"},{"key":"e_1_3_4_36_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.psychres.2019.112578"},{"key":"e_1_3_4_37_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jaac.2017.10.008"},{"key":"e_1_3_4_38_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jaac.2011.08.003"},{"key":"e_1_3_4_39_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.psychres.2021.113854"},{"key":"e_1_3_4_40_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jaac.2020.08.006"},{"key":"e_1_3_4_41_1","doi-asserted-by":"publisher","DOI":"10.1097\/00004583-200102000-00017"},{"key":"e_1_3_4_42_1","doi-asserted-by":"publisher","DOI":"10.1002\/da.22232"},{"key":"e_1_3_4_43_1","doi-asserted-by":"publisher","DOI":"10.1097\/JCP.0b013e318204b117"},{"key":"e_1_3_4_44_1","doi-asserted-by":"publisher","DOI":"10.3109\/08039488.2014.941395"},{"key":"e_1_3_4_45_1","doi-asserted-by":"publisher","DOI":"10.1017\/S1092852921000870"},{"key":"e_1_3_4_46_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.brat.2013.09.007"},{"key":"e_1_3_4_47_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.janxdis.2006.01.006"},{"key":"e_1_3_4_48_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jaac.2020.01.026"},{"key":"e_1_3_4_49_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jad.2021.10.047"},{"key":"e_1_3_4_50_1","doi-asserted-by":"publisher","DOI":"10.3390\/jpm11111188"},{"key":"e_1_3_4_51_1","doi-asserted-by":"publisher","DOI":"10.1089\/cap.2018.0160"},{"key":"e_1_3_4_52_1","doi-asserted-by":"publisher","DOI":"10.1002\/da.23064"},{"key":"e_1_3_4_53_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jaac.2014.12.007"},{"key":"e_1_3_4_54_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.psychres.2017.12.034"},{"key":"e_1_3_4_55_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jaac.2019.08.480"},{"key":"e_1_3_4_56_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jaac.2016.07.768"},{"key":"e_1_3_4_57_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1469-7610.2007.01875.x"},{"key":"e_1_3_4_58_1","doi-asserted-by":"publisher","DOI":"10.1007\/s10567-019-00303-2"},{"key":"e_1_3_4_59_1","doi-asserted-by":"publisher","DOI":"10.1037\/0033-295X.112.3.658"}],"container-title":["Journal of Child and Adolescent Psychopharmacology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.sagepub.com\/doi\/full-xml\/10.1089\/cap.2023.0018","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1089\/cap.2023.0018","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1089\/cap.2023.0018","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,4,28]],"date-time":"2026-04-28T14:56:41Z","timestamp":1777388201000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.sagepub.com\/doi\/10.1089\/cap.2023.0018"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,8]]},"references-count":58,"journal-issue":{"issue":"6","published-print":{"date-parts":[[2023,8]]}},"alternative-id":["10.1089\/cap.2023.0018"],"URL":"https:\/\/doi.org\/10.1089\/cap.2023.0018","relation":{},"ISSN":["1044-5463","1557-8992"],"issn-type":[{"value":"1044-5463","type":"print"},{"value":"1557-8992","type":"electronic"}],"subject":[],"published":{"date-parts":[[2023,8]]}}}